No one really truly knows if FOV (Floater Only Vitrectomy) causes cataracts. In my experience, while vitrectomy (done for all causes) does increase cataract formation, a straight and simple vitrectomy in young patients with no existing cataracts at the time of surgery are probably safe.
Cataracts and Cataract Surgery
Cataracts are just like grey hair. With or without FOV, everyone eventually gets them. Most often, cataracts develop as we get older, but it’s not uncommon to find cataracts in 20 and 30 year olds. There are congenital types of cataracts, too.
Cataracts are a fact of life.
Cataracts may be influenced by a variety of factors; extensive UV exposure, trauma, previous eye surgery, etc. Cataract surgery is the most common surgery performed and also carries a technical success rate of over 99%!
As with any intraocular eye surgery, there are risks. The risk of blindness from infection or retinal detachment are the most worrisome to any eye doctor, though the risks are very small.
Vitrectomy and Cataracts
To my knowledge, there are several retrospective studies which associate vitrectomy with increased cataract formation. This does not mean, however, that FOV (simple vitrectomy only for removal of floaters) causes cataracts.
Let me explain.
Vitrectomy surgery allows a retina specialist to operate on a variety of retinal problems: retinal detachment, epiretinal membranes, macular holes, vitreous hemorrhage, complications of cataract surgery, floater removal, etc.
Some of these procedures vary in duration and also require use of intraocular gas to be injected at the end of surgery. These are potential factors leading to cataract formation. Also, many diabetic patients require vitrectomy surgery. Diabetic patients get cataracts earlier in life than non-diabetics.
So if you consider vitrectomy, performed for all reasons and all diseases, cataract formation may increase, but there is no prospective study (the best studies are blinded and prospective) which clearly indicates that FOV, vitrectomy only to remove floaters, increases the rate of cataract formation.
If cataracts form in everyone, then cataract surgery may be expected in most individuals.
Patients with floaters are suffering from decreased vision. There seems to be an unfounded concern about cataract formation following FOV, yet both are correctable conditions.
1. If there is no evidence of cataract at the time of FOV, in my opinion, there is little chance a cataract will form rapidly after surgery.
2. If you have a cataract at the time of FOV, you will likely need cataract surgery after FOV, but you’d need it anyway.
Randall V. Wong, M.D.
Ophthalmologist, Retina Specialist